title: Perioperative course and accuracy of screw positioning in conventional, open robotic-guided and percutaneous robotic-guided, pedicle screw placement.
abstract: Robotic-guided and percutaneous pedicle screw placement are emerging technologies. We here report a retrospective cohort analysis comparing conventional open to open robotic-guided and percutaneous robotic-guided pedicle screw placement. 112 patient records and CT scans were analyzed concerning the intraoperative and perioperative course. 35 patients underwent percutaneous, 20 open robotic-guided and 57 open conventional pedicle screw placement. 94.5% of robot-assisted and 91.4% of conventionally placed screws were found to be accurate. Percutaneous robotic and open robotic-guided subgroups did not differ obviously. Average X-ray exposure per screw was 34 s in robotic-guided compared to 77 s in conventional cases. Subgroup analysis indicates that percutaneously operated patients required less opioids, had a shorter hospitalization and lower rate of adverse events in the perioperative period. The use of robotic guidance significantly increased accuracy of screw positioning while reducing the X-ray exposure. Patients seem to have a better perioperative course following percutaneous procedures.
authors.affiliation: Department of Neurosurgery, Georg-August-University of Göttingen, Robert-Koch-Strasse 40, 37075 Göttingen, Germany. sven.kantelhardt@web.de
authors.forename: Sven Rainer
authors.initials: SR
authors.lastname: Kantelhardt
authors.forename: Ramon
authors.initials: R
authors.lastname: Martinez
authors.forename: Stefan
authors.initials: S
authors.lastname: Baerwinkel
authors.forename: Ralf
authors.initials: R
authors.lastname: Burger
authors.forename: Alf
authors.initials: A
authors.lastname: Giese
authors.forename: Veit
authors.initials: V
authors.lastname: Rohde
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001863:Bone Screws; D005260:Female; D006801:Humans; D016268:Internal Fixators; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning; D059035:Perioperative Period; D011859:Radiography; D012371:Robotics; D013123:Spinal Fusion / Q000295:instrumentation / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000295:instrumentation / Q000379:methods*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000601:surgery*